Stress-induced cardiomyopathy, so-called Takotsubo cardiomyopathy, has recently been reported in Japan. Stress-induced cardiomyopathy is characterized by transient left ventricular apical dysfunction and ballooning, with normal coronary angiographic findings. We describe a rare case of stress-induced cardiomyopathy associated with lung adenocarcinoma presenting as hyponatremia.

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• Hyponatremia and takotsubo syndrome: a review of pathogenetic and clinical implications
  Kenan Yalta, Orkide Palabıyık, Muhammet Gurdogan, Ertan Yetkın
  Heart Failure Reviews.2023; 29(1): 27.     CrossRef

Pulmonary mucoepidermoid carcinoma (MEC) is a rare form of lung cancer that originates from submucosal glands of tracheobronchial tree. Unlike low-grade tumor with benign nature, high-grade case is even rarer and has aggressive clinical features with no definite treatment option. Here, we report a case of high-grade pulmonary MEC with fulminant clinical course. A 74-year-old man presented with cough, sputum and mental change. Chest imaging showed massive mediastinal lymphadenopathy with obstructive pneumonia, and multiple metastases in lung and adrenal gland. Bronchoscopy showed polypoid masses obstructing right main bronchus and bronchus intermedius. Histopathology revealed a mixture of glandular structure lined with mucussecreting cells and nests of squamoid cells with nuclear atypia and pleomorphism, which is compatible with high-grade MEC. We intensively treated the patient with combination antibiotics and ventilator care. However, the patient did not respond to the treatment and rapidly deteriorated, and finally expired a month after diagnosis.

No abstract available in English.

Choriocarcinonla is very rare malignancy, accounting for less than 1% of all testicular germcell tumor. However, it is an important disease in the field of oncology, as it represents ahighly curable malignancy. and one in which the incidence is focused on young patients attheir peak of productivity. In nonserninomatous germ cell testis tumor, assessment of prognosticfactors is related to develop a basis for more rational therapy for each individual patient.Along with prognostic staging, appropriate treatment shoud be applied to each patient to improve disease-free survival. And. surgical resection of residual masses after cisplatin-based chemotherapy is an established adjuvant to chemotherapy, because complete remission can be improvedabout 10% with appropriately timed complete resection of residual diseases. So, we reporta case of a 27-year old male patient with testicular choriocarcinoma who presented with multiplelung metastases after radical orchiectomy. He recieved lung wedge resection after 8 cycles ofcisplatin, etoposide, ifosfamide combination chemotherapy. and complete remission was confirmed and maintained.

Although the role of surgical management of metastatic disease from primary carcinoma of the coln and recutm is still controversial, resection of hepatic metastasis improves survival rate of patients with primary colorectal carcinoma treated locally. The lung is the most common site of extra-abdominal metastasis following resection of a prymary colorectal tumor and not amenable to curative therapy.

It is possible to resect the pulmonary metastasis in selected patients following resection of colorectal cancers, but the 5-year survival rates are ranged from 9% to 57%. Authors report a case of resection of pulmonary metastasis occured 3 years after resection of primary colon carcinoma.

The diffuse interstitial lung diseases are a heterogeneous group of diffuse inflammatory disorders of the lower respiratory tract characterized by derangements of the alveolar walls and loss of functional alveolar capillary units. The most common causes of diffuse interstitial lung diseases are idiopathic pulmonary fibrosis, sarcoidosis, collagen vascular disorders, hypersensitivity pneumonitis and pneumoconiosis. Especially, the miliary tuberculosis is also leading cause in Korea, but pulmonary tuberculosis presenting as diffuse interstitial lung disease except miliary tubercuaosis is rare. We report a case of pulmonary tuberculosis presenting as diffuse interstitial lung disease associated with the tyrnphadenopathy of mediastinum and abdomen.

Ovarian cancer is generally primary cancer and less frequently originates from metastasis from non-gynecological cancer. Ovarian metastasis from lung cancer represents only 2~4% of all ovarian metastatic cancers. We report a case of ovarian metastasis of non-small cell lung cancer with epidermal growth factor receptor mutation. The patient underwent cytoreductive surgery for the ovarian mass and erlotinib therapy for the metastatic lung cancer. Erlotinib therapy markedly decreased the size of lung mass.

Small cell lung cancer is primarily treated with chemotherapy. For patients with end-stage renal disease (ESRD), systemic chemotherapy is often challenging since renal excretion of chemotherapeutic agents might be decreased due to impaired renal function, leading to increased toxicity. No consensus is made so far regarding appropriate dosage and combination of chemotherapeutic agents for patients on hemodialysis. We report two cases of chemotherapy without significant toxicity in small cell lung cancer patients who were on hemodialysis for ESRD.

A 54-year-old man was diagnosed as syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 7 days after lung transplantation, whereas the preoperative serum sodium level was normal. Hypertonic saline infusion with furosemide did not improve hyponatremia, however, tolvaptan corrected his serum sodium levels from 123 mEq/L to 131 mEq/L. Seven days after maintenance of tolvaptan, this drug was discontinued and hyponatremia did not occur. Herein, we report a case of SIADH after lung transplantation treated with tolvaptan.

Vasovagal syncope is one of the most common causes of transient syncope during anesthesia for elective surgery in patients with a history of syncope and requires special attention and management of anesthetics. The causes and pathophysiological mechanism of this condition are poorly understood, but it has a benign clinical course and recovers spontaneously. However, in some cases, this condition may cause cardiovascular collapse resulting in major ischemic organ injury and be life threatening. Herein we report a case and review literature, regarding completing anesthesia safely during an elective surgery of a 59-year-old female patient with history of loss of consciousness due to suspected vasovagal syncope followed by cardiovascular collapse and cardiac arrest, which required cardiopulmonary resuscitation and insertion of a temporary pacemaker and intra-aortic balloon pump immediately after a fine-needle aspiration biopsy of a lung nodule located in the right middle lobe.

The rearrangement of c-ros oncogene 1 (ROS1) has been recently identified as an important molecular target in non small cell lung cancer (NSCLC). ROS1 rearrangement and epidermal growth factor receptor (EGFR) mutation were mutually exclusive each other in previous studies, and the clinical implication of co-existence of the two genetic alterations has not been determined. We report a case of 46-year-old female never-smoker NSCLC patient whose tumor harbored ROS1 rearrangement and EGFR mutation concomitantly. She had undergone curative surgery for stage IIIA NSCLC, and the recurrence in left pleura and brain occurred at 2 years after the surgery. She received several lines of chemotherapy including docetaxel plus carboplatin, erlotinib, pemetrexed, and gemcitabine. Erlotinib therapy showed a favorable treatment response with progression-free survival of 9.5 months and partial response of tumor on radiologic evaluations. This case represents a successful erlotinib treatment in a NSCLC patient with concurrent ROS1 rearrangement and EGFR mutation.

Radiation recall dermatitis refers to an acute inflammatory reaction in a previously irradiated field triggered by the administration of certain drugs days to years after the exposure to radiation. Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor and is an effective treatment for patients with advanced stage of non small cell lung cancer (NSCLC). Here, we report a rare case of gefitinib induced radiation recall dermatitis. A 52-year-old woman with a metastatic NSCLC had received a palliative radiation therapy of 20 cGy on spine metastasis area (C6-T6). After 24 days of receiving radiation therapy, she had started to take gefitinib. Eight months after taking drug, pain, swelling and erythema of skin were occurred on previously irradiated field. These symptoms were resolved after the cessation of gefitinib for 6 days and the topical use of steroid.

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• Gefitinib
  
  Reactions Weekly.2014; 1490(1): 21.     CrossRef

Amiodarone has been widely used for supraventricular and ventricular arrhythmias and many patients benefit from its effectiveness in treating potentially life-threatening arrhythmias. However, this drug can cause multi-organ toxicity, including amiodarone-induced pulmonary toxicity (APT). Not only does amiodarone have a long half-life but also is lipophilic and therefore can easily accumulate in tissues. Hence, it is difficult to monitor therapeutic levels and side effects, making it difficult to predict toxicities. In this case, we describe multi-organ complications secondary to amiodarone use, especially APT combined with pneumonia with atypical pathogens and pulmonary hemorrhage. The patient reached a high cumulative dose of amiodarone despite a low maintenance dose of amiodarone. This case highlights an unusual presentation of APT with multi-organ toxicity and we review articles regarding the association between the cumulative dose of amiodarone and amiodarone-induced toxicities.

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• Amiodarone
  
  Reactions Weekly.2014; 1492(1): 8.     CrossRef

Small cell lung cancer accounts for about 20% of all lung cancers. At the time of diagnosis, the majority of patients already have metastasis. The liver is one of the most common sites of distant metastasis of lung cancer. Small cell lung cancer arises from neuroendocrine cells which produce hormone, hormone producing granules can be seen under electron microscope . A 65-year-old male was admitted to hospital because of jaundice and right upper quadrant pain. The chest roentgenogram and chest computed tomography(CT) scan showed a 3 cm mass in right upper lobe with bilateral mediastinal lymphadenopathy and right pleural effusion. The abdomen CT scan revealed multiple masses in the liver with heterogenous pattern suggesting metastatic orgin. Though the immunohistochemistry and electron miscroscopy, he was diagnosed as metastatic small cell lung cancer of liver. We report a case of the Immunohistochemical and Electron Microscopic Observation of Metastatic Small Cell Lung Cancer of Liver.

No abstract available in English.

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• Preoperative Cardiopulmonary Exercise Test Associated with Postoperative Outcomes in Patients Undergoing Cancer Surgery: A Systematic Review and Meta-Analyses
  Daniel Steffens, Hilmy Ismail, Linda Denehy, Paula R. Beckenkamp, Michael Solomon, Cherry Koh, Jenna Bartyn, Neil Pillinger
  Annals of Surgical Oncology.2021; 28(12): 7120.     CrossRef

Acute eosinophilic pneumonia is characterized by acute febrile disease with diffuse interstitial infiltration on chest radiography, eosinophilic infiltration of lung parenchyma on lung biopsy and good response at corticosteroid therapy. There has been several reports that support cigarette smoking recently, even though the pathogenesis is not clear. We encountered a case of acute eosinophilic pneumonia induced by cigarette smoking, who, being a 20-year-old man, presented with acute onset of fever after his first cigarette smoking. His clinical symptoms and the infiltrations on onset x-ray improved after a treatment with corticosteroid.

We report a case of extensive stage SCLC with EAS confirmed by immunohistochemical stain of ACTH in tumor cells who died early due to rapidly progressive acute respiratory distress and pneumonia before the start of chemotherapy and corticosteroid blocking agent. Through our case, we learn how important early diagnosis and treatment of EAS associated with SCLC are and hope to apply to other cases from now on.